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Home My WebLink AboutBLDE-23-005042 of r Commonwealth of Official Use Only fE Massachusetts Permit No. BLDE-23-005042 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] • APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:3/14/2023 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. . Location(Street&Number) 286 OLD MAIN ST Owner or Tenant WELCH ANNE E TR Telephone No. • Owner's Address ANNE E WELCH REVOCABLE TRUST, 300 SUMMER ST NO 27, BOSTON, MA 02, Is this permit in conjunction with a building permit? Yes 0 No 0 ppropriate Bolt ^ Purpose of Building Utility Authorization 12267661 , A fly{, Existing Service Amps Volts Overhead 0 Undgrd ! l New Service 100 Amps Volts Overhead 0 Undgrd 0 'o:rr. ` ' • •rs Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Temporary service. Completion of the following table may be waived by the Inspector of Wires. • No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: TYLER W PAYNE Licensee: Tyler W Payne Signature LIC.NO.: 22091 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:5 JANS PATH, HARWICH MA 026452458 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But my signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 Commonwealth of Massachusetts . ornu.d use Only 1 � `,' Permit No. ( 5-Soy4 Z� 1 ,v; Department of Fire Services .-I Occupancy and He Checked d BOARD OF FIRE PREVENTION REGULATIONS ;4pcsyq;ail (leasrhl+nk) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK An work to be performed re accordance.with the tMassashusetts Electrical Codc(MEC).527 CMR 12 00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: o313,A lab City or Town of: NI cwv4,,,eNs3,kft To the Inspector of Wires: By this application the undersigned ices notice of his or her intention to perform the electrical work dc'cribcd below. Location(Street&Number) p 86 d 42_ t .h._54.4-e,4.'k- Owner or Tenant Aywkre. tt 6rs, a � Telephone No.11ai- (p1.3Qac Owner's Address 'I 6 ( e .py9�. $Levert bfee1Wy4ke,. M a Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building b lNAe_1I yt Utility Authorization No.i 2.2 4,1(,-44 Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters New Service 1 O D Amps 1 Volts Overhead le,. Undgrd 0 No.of Meters t Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ONe.30,1ec t,_ 1 '-wf sc.*V;C.t Completion of the followin table nine be waived bi the inspector of Wars. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Nio.of 7 oral Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming pod Above In- ,No.of Emergency Lighting g grad. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.of Detection and Initiating Devices otal No.of Ranges No.of Mr Cond. Tons No.of Alerting Devices I'tio.of Waste Disposers Heat Pump"Number 'Cons KW No.of Self-Contained • p� Totals:_ Detection/Alerting Devices Lnof Dishwashers Space/Area Heating KW Local❑ �fontcipal Connection ❑Other, Heating Appliances KW Security Systems:* No.of Dryers No.of Devices or Equivalent INo.of Water Kam, No.of Nu.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivaknt No.Hydromassage Bathtubs No.of Motors Total HP T'eelecommunications Wiring: No.of Devices or Equivalent OTHER: Minch additional detail if desired.or as required be the Inspector of Wires Estimated Value of Electrical Work: t When required by municipal policy.) Work to Start: Impactions to be requested in accordance with MEC Rule 10.and upon completion. INSURANCE COVERAGE: Unless waived by the on ner,no permit for the performance of electrical work may issue unlc,s the licensee pros ides proof of liability insurance including"completed operation"coverage or its substantial equi%alert. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office, CHECK ONE: INSURANCE U. BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME:?Ik4NE ELECTRSC, I NC, �/9 LIC.NO.:53OLy-g Licensee: Ty LE Yd• y NE Signature q LIC.NO.12 t,04 - (If applicable,ricer"exempt"in t licer se number line. '�Mj ,` Bus.Tel.'s o.: .. • s e 1ji ' Address: P.O. Box t01 _ souihrift ri 1-CN V '%02 D,w1 Alt.Tel.N i • 'NI.4FW *Security System Contractor I.icense required for this work:if applicable,enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature helm,I hereby waive this requirement. I am the(check one)❑on ner ❑owner's agent. Owner/Agent [PERMIT FEE:$ Signature Telephone No.